Statement from ICOS on the HIA ruling regarding Private Health Insurance for non-EEA students

The HIA’s determination announced earlier this year that non-EEA students should be regarded as “ordinarily resident” in the state after one year of study has significant cost implications for those students who wish to continue their studies in Ireland and is potentially damaging to Ireland’s ambition to increase the numbers of international students coming to Ireland for both higher education and English language programmes. These ambitions are clearly stated in the Government’s 2016-2020 International Education Strategy, “Irish Educated Globally Connected”.

Currently private medical insurance is not a significant cost component of the overall cost of study in Ireland which is as it should be as students and young people in general represent a low risk group. Non-EEA students, unlike EU students and citizens generally however, are required to hold private medical insurance in order to comply with immigration requirements. Non-EEA students on full-time programmes which are listed on the Interim List of Eligible Programmes (ILEP) will normally be offered a Stamp 2 residence permit on completion of the registration process which is operated by INIS with support from An Garda Síochána (for registrations outside Dublin).

INIS has set out minimum requirements for the kind of private medical insurance that non-EEA students are currently required to hold and there are a number of products on the market – some for over 20 years- which satisfy INIS and also safeguard providers and the students themselves from having to bear the potentially high costs of medical treatment should they become ill or are injured as a result of an accident. The general principle also being, of course, that non-EEA students do not become a burden on the Irish public health system.

The repatriation of students in case of serious illness or death has been a particularly important element of the cover provided by the insurance products most favoured by students and providers up to now. In fact, the most popular products on the market such as the ODON MediCare policy underwritten by Chubb emerged precisely to fill a need identified by providers for this kind of cover. Unfortunately, there are a small number of international student deaths every year and the consequences would be even more catastrophic for the affected families if they were not able to draw on their insurance policies to cover repatriation and other family supports at such a difficult time.

The Irish Council for International Students (ICOS) which is a representative body for Higher Education Institutions (HEIs) in Ireland with 32 members has previously communicated its concerns with regard to the HIA determination including to the High Level Group on International Education on which ICOS is represented. Our main concerns are outlined below:

In ICOS’ view, the HIA determination that non-EEA students beyond their first year of study be regarded as “ordinarily resident” in the state is not coherent with Ireland’s internationalisation strategy and current immigration policy which clearly states that non-EEA student status (Stamp 2) is not counted in terms of earing longer term residency rights in Ireland. Non-EEA students are “temporarily” resident in the state (limited to 7/8 years) therefore it is unclear why they should be required to contribute to our health care system and be levied for benefits they will never enjoy into the future.

Ref: “Insurers selling health insurance contracts to persons “ordinarily resident in the State” are required to be registered with the HIA and to comply with the provisions of the Health Insurance Acts such as community rating, open enrolment, lifetime cover and minimum benefits." (HIA Jan 2017)

As already stated, the HIA determination will result in a significant increase in health insurance costs for continuing students and a restriction in choice. This will undoubtedly influence some students to consider other educational destinations including the UK which has dedicated health care insurance options for international students and recognises their unique status while also ensuring that non-EEA students make a contribution to the NHS.

ICOS is greatly concerned that there are significant deficits in HIA registered plans from an international student and HEI perspective including but not limited to: the absence of cover for repatriation or family support in the case of serious illness or death of the insured; Extended waiting periods (usually up to 6 months) before claims can be made; The absence of cover for existing conditions.

ICOS is also concerned about the uncertainty caused to students and their advisers with regard to the validity of their insurance plans for immigration compliance which has stemmed from the HIA ruling. Uncertainly about the continuing costs of education in Ireland will inevitably lead to some students choosing other destinations.

ICOS believes that the current difficulty caused by the HIA ruling provides the Government and relevant agencies opportunity to find a solution which is fair to non-EEA students and does not dis-incentivise study in Ireland. Health insurance cover for international students is a requirement in most countries. However, approaches and models of cover and options available vary considerably – from statutory health levies to mandatory special travel and insurance plans or combinations of both. Any solution for Ireland needs to balance the needs of all stakeholders:

Students need clear advice about suitable and affordable insurance plans which will satisfy immigration requirements and offer them access to health care in Ireland in a timely manner and protect them in crisis situations;

HEIs need to know that students have sufficient cover to treat serious illness (including psychiatric illness) or injury. Cover should also include repatriation costs and provision for support from immediate family members in the case of death or serious illness/injury of the student.

The Government needs to know that temporary residents in the State (including students) have access to health care when needed but the associated costs should not amount to an undue burden on the State which outweighs any other benefits.

The current HIA ruling does not, in ICOS' view, balance the needs as described and needs to be re-visited.